Table 4.

Severe manifestations of P. falciparum malaria in adults (WHO 2000, adapted WHO 2011)[77,78]

Prognostic value	Clinical manifestations and laboratory findings	Frequency
(?) no data	Prostration	+++
+	Impaired consciousness (score <11 on the Glasgow Coma Scale)	++
+++	Acute respiratory distress	+
++	Multiple seizures	+
+++	Circulatory collapse (systolic blood pressure <80 mm Hg with features of peripheral circulatory failure)	+
+++	Pulmonary oedema (radiological)	+
++	Abnormal bleeding (clinically defined)	+
+	Jaundice (clinically defined or serum bilirubin >50 mol/L	+++
+	Macroscopic haemoglobinuria	+
+	Severe anaemia (haemoglobin <5 g/dL or haematocrit <15%)	+
+++	Hypoglycaemia (blood glucose concentration <2.2 mmol/L)	++
+++	Acidosis (pH <7.35 or plasma bicarbonate <15 mmol/L)	++
+++	High plasma lactate (>5 mmol/L)	++
++	High parasitemia (especially 2% in non-immune patients and 5% in semi-immune patients)	+
++	Acute renal failure (serum creatinine > 265 μmol/L and 24-hour urine output <400 mL)	+++